In a post last week, I predicted that the virus-sharing dispute that has arisen between Indonesia and the WHO, despite some encouraging news, was far from over. This article from Bloomberg News seems to confirm that suspicion:
Indonesia is disrupting the 50-year- old system that supplies the world with flu vaccines by demanding compensation from drugmakers GlaxoSmithKline Plc and Novartis AG.
Siti Fadilah Supari, Indonesia's Health Minister, stopped sending the World Health Organization live viruses taken from birds and humans that scientists use for vaccines in December. Supari said shipments will resume only after the WHO helps Indonesia negotiate free supplies of pandemic-flu shots and money to build vaccine plants, the first-ever such requirement.Without the latest versions of the avian-influenza virus, doctors can't produce the most up-to-date vaccines. The WHO said last week it will press companies to meet some of Indonesia's needs. Glaxo Chief Executive officer Jean-Pierre Garnier will meet with WHO director-general Margaret Chan today to discuss the dispute, said Nancy Pekarek, a company spokeswoman for the London-based drugmaker.
``I cannot tolerate this misuse of our viruses,'' said Triono Soendoro, who runs the flu research for Indonesia's health ministry. His Jakarta lab stores the samples Indonesia says it will withhold until an agreement is brokered.
Indonesians spend an average of $30 annually on health care, compared with $5,700 in the U.S., according to the World Health Report. Glaxo's flu vaccine costs $6 to $11 a shot in markets around the world, and receiving a flu shot from a doctor can cost as much as $59 in Jakarta.
....
The WHO is working on an agreement that would cover access to seasonal and avian flu, including the H5N1 virus WHO says has killed at least 170 people since late 2003, mostly in Asia.
Following a two-day meeting last week with Indonesia, Thailand and other nations hit by avian flu, WHO officials pledged to develop new guidelines regulating how the agency distributes viruses now provided free by poor nations.
The new rules may require the WHO to disclose for the first time which companies use the viruses to make vaccines, said David Heymann, the agency's assistant director general for communicable diseases, who met with the countries' health officials in Jakarta. WHO also will ask the drugmakers to provide free vaccine for use by poorer countries, Heymann said
[Continue reading at bloomberg.com]
The article goes on to note something that I haven't seen yet in the mainstream press, or by WHO itself, though it's been more or less obvious to people following the news: The WHO has stopped acknowledging/confirming cases of H5N1 in Indonesia. On its website, the number of cases and deaths in that country hasn't budged since the last "Situation Update" on January 29.
Of course, blogs have been closely following local news sources, so we can be pretty confident that the current count, as of April 6, is: 93 cases and 73 deaths.
It's not clear whether this is because Indonesia has stopped reporting cases to the WHO (at all), or whether the WHO has stopped confirming those reports. However, we know that the WHO had been providing updates (including reports of 5 deaths) through the end of January, a full month after they stopped receiving viral samples, so clearly it's not impossible for the WHO to confirm deaths from H5N1 without having access to viral samples for each individual case.
Either way, to me it suggests a severe breakdown in cooperation that goes far beyond the debate about ownership of physical viral samples.

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